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31 December 2006

He came to us today from the golden rescue folks -- between 1.5 and 2 years old, 55 pounds, and a littl furball. They call him Red in their system, but then they found out his real name was Lucky(he answers to it). I've morphed it a little into Luckily: Luckily, I found you! Happy New Year!

At the gym yesterday I took the water aerobics class, up to the point where the instructor started doing things that violated the hip precautions (jumping with bent knees,bringing knees to chest). It was fun and easy. Today I go to the gym to walk the treadmill and ride the bike -- I'm doing different things every day. Very, very slowly, my walk without the cane is improving and putting my full weight on the joint is hurting less.

Just in time. The Golden Retriever Rescue people called me yesterday and they have a new golden for us! I think we get him today. He's two years old and his name is Red. I'll have to change that.

What's perfect is that I always stay home for New Year's Eve, and it will be Red's first night. He won't think he has a mother who eats in the restaurant every night :-)

29 December 2006

I'm on the way to the gym. I can now do the leg press and the abductor machines in addition to the bike and the treadmill. But I'm losing patience with this physical therapy stuff.

Yesterday when I went to physical therapy, I gave Kate, the PT, a piece of my mind. I told her I wasn't getting better fast enough, and I wondered if there was anything wrong.

She sat me down and, while stretching my hip flexor, gave me a piece of HER mind. She said I was on the fast track, and that many people at my stage weren't even working on their abductor strength yet; they were still working on ADLs (activities of daily living). She told me that most people were not shown how to get down on the floor or how to pick things up off the floor by putting one leg up behind them, because they weren't agile enough to do it. And she told me it would be about three months before I could even tell how my walk would look. Basically, her message was "don't complain; you are far ahead of everyone else."

While Dr. Whirlow didn't tell me it would be the easiest rehab because of the weakness in all my muscles, she didn't really EMPHASIZE the length of the rehab. She did say it would be work. But somehow I had the idea that after six weeks, something magical would occur and I would BE HEALED.

Actually, this isn't so. I can walk miles with the cane, and I have lost most of my pain, but when I try to walk unaided, I can see how far I am from finished with rehab. This makes me impatient, because I was willing to give it six weeks, but not six months.

So here I go, over to the gym. Today I will not walk in the pool with the underwater MP3 player I got for Christmas, but I will ride the bike with my regular IPOD. I vary these exercises in case one works better than another :-) And I will continue my magical thinking: one of these days, I will be healed.

28 December 2006

The Stealthmode server was moved yesterday, and the link to my Stealthmode blog is down. I'm frustrated, which doesn't contribute to my recovery from surgery, so I will post my business blog post here and cross-post it when my blog comes up again...

John Edwards has chosen to announce his candidacy on YouTube, and Paul Kaputzka has covered it for NewTeeVee, part of Om Malik's blog. Because of my advanced age and non-technical background, I'm careful which blogs I comment on, for fear of being considered a little old lady with a cane. But if it's one place where I'm experienced, it's politics, so here goes.I can't let my friend Scoble, one of the most honest and open journalists on the planet, get excoriated for leaving his wife Maryam and son Patrick over Christmas vacation to go to New Orleans' Ninth Ward,, Iowa, and New Hampshire -- not exactly top winter vacation destinations.This is ridiculous. I am as pissed at reporters who are in the pocket of politicians as anyone, but just because someone rides on a campaign plane does not put them in anyone's pocket. For Edwards, who strikes me as an earnest man, this is a way to reach out to new constituencies who don't vote (young people) and should. For Scoble, it's a way to document how social media is influencing politics. It wouldn't matter who the candidate is.

27 December 2006

I should probably mention that I treat my cane the way I treat eyeglasses; I don't use the Walgreen's $20 special. Instead, I make it part of my wardrobe and my fashion statement. This probably comes from my yoga practice of acceptance.

25 December 2006

Merry Christmas! Five weeks ago today, I was preparing for surgery. Waking up hungry and not being able to eat because of the anaesthesia. Today I get to eat all day long, going from party to party.

I'm weaning myself slowly from the cane, but it isn't easy. I still can't bear all the weight on the operated leg without bracing the other leg against it. For you yogis, I can do tree pose, but not king dancer. And when I walk caneless, I limp. So I can see it will be a long haul to develop these muscles again. On the other hand, I've gotten up quite a head of steam on the cane, so I am walking fast again. I'm beginning to think a lot of this is the problems in my back, which haven't been able to be fixed by yoga in two months. This deserves more investigation.

Club shows firms how to use the Net's social side

Yet even the handful of the 40 or so attendees at a recent Social Media Club-Phoenix meeting who could not define these Internet communication methods saw the value in learning about them.

"It's where things are going," said Rex Reynolds of HQ Quotes LLC. He said he attended to learn how to market his business and receive more immediate public feedback through online communication like blogs or online journals.

He said he saw the meeting as a free tutorial. "The intellectual capital in this room is amazing," he said.

The alphabet-soup names represent a shift in the way business, from issuing corporate news releases to generating clients for a home-based business, will be done in the future.

Pioneers in the Valley's new media enterprises, along with teachers, life coaches and professionals in non-profit groups, public relations and marketing, attended to explore using Internet tools to find customers and compatriots.

Making new communication methods a part of a marketing plan has become increasing important to businesses that want to more closely monitor and understand their target markets, Sheila Kloefkorn, president of the Phoenix chapter of the American Marketing Association said in a telephone interview.

She noted that social-networking sites like MySpace.com and Facebook.com provide opportunities for businesses to learn more about what makes their target customers tick.

"I think the real opportunity is that more and more people want to control their media, so you hear a lot about consumer-generated media, meaning we all want to go on and have our own little community of just the things we care about," Kloefkorn said in an interview last week.

She also is president of KEO Marketing Services in Tempe.

The power and perks of social media were illustrated in a story told by club organizer Francine Hardaway, president of Stealthmode Partners, a business consulting firm in Phoenix.

During hip-replacement surgery at Scottsdale Healthcare Shea, she began blogging about her recovery. Word spread that she was writing about her experience as a patient for all in Internet land to read.

"They started treating me like a VIP," she said. "The thing about social media for me is its raw power."

At times, the group conversation steered toward geek-speak, but facilitators refocused the conversation on layman discourse.

Marketing and public-relations practitioners like Amanda Vega see the potential for big opportunities for clients who use blogs, social-networking Web sites and other online venues to tell the public about their company.

Companies that don't incorporate such outlets into their marketing efforts, she said, run the risk of disenfranchising potential customers, especially younger ones.

"There are a lot of younger audiences that will not buy from people who do not have a Web site, specifically if you can't buy online," said Vega, owner of Amanda Vega Consulting in Phoenix and a club participant, "They don't trust you. You have to have some sort of online presence."

Vega noted that some of the public companies her firm represents have turned to online forums such as blogs to disseminate U.S. Security and Exchange Commission filings, which can help garner more attention than the traditional news release.

The Phoenix chapter of the Social Media Club had its first meeting in November and is still in the early stages of defining its agenda.

"The water's warm. There aren't any sharks in it," said attendee Steve Epstein, chief technical officer at Media2Eye.com. Epstein's comments were aimed at people interested in aspects of social media but perhaps intimidated by the terms and their lack of knowledge.

The Social Media Club's headquarters is in San Francisco. Since it began a year ago, clubs have also launched in Miami, Seattle and New York.

24 December 2006

Tomorrow will be five weeks since the surgery. I was really sore (muscles) in the quads and glutes from the walking on the treadmill yesterday, but it taught me that there's no exercise to substitute for walking itself, so I will do more of it.

My high school class, in preparation for its 50th reunion in 2008, has started a Yahoo group. One of the women on it has read this blog and asked for more information about my decisions. Because I spent some time replying to her, I'm going to re-post my answers, sanitizing them for privacy's sake:

Where do I begin? My X-ray was so obvious that I never had an MRI. And I already knew that I had scoliosis, spondylolisthesis, and stenosis in my back. But I wasn't in pain from my back after I started to do yoga. Naturally I tried first to treat my hip with yoga. It didn't work at all. That being said, anyone else might want an MRI. Some symptoms are slightly different from mine; I couldn't get my legs straight out on the floor because I had compensated for the hip for so long that my psoas and quadratus lumborum had tightened and weakened, even with the yoga. I was also losing strength in the gluteus medius. I had lost a lot of muscle strength of which I was unaware. All I knew was that I couldn't balance on my left leg. I never bothered trying to figure out why :-)

Why I chose the procedure I did: I knew I wasn't a candidate for a resurfacing. My X-ray said my femur was literally jammed into my acetabulum; I had collapsed into the hip on that side. This did happen within a six month period.

I went to a doctor who does the minimally invasive procedure, and he was very cavalier about the impact of a hip surgery on the delicate balance of my back -- he said it wouldn't matter. Ten years of yoga study told me it would. Everything's connected.

So I went to a doctor who does the normal procedure -- a woman. She said that to position the joint correctly so that it didn't throw my pelvis/back out of line, she had to see into the joint space more clearly than the minimally invasive procedure would allow. She said I wouldn't have a large incision, however, because I wasn't fat. That was on the first visit.

She sent me for pre-op physical therapy, and the PT there told me that she had one surgeon client who did nothing but revisions on minimally invasive surgeries that didn't work, and that the failure rate was higher than one would like.

In further discussions with Dr. Whirlow, I cried over the possibility that I could no longer do yoga after the surgery because I needed it for my back. She then told me that there was a new theory that if you put a larger femoral head in, there was greater range of motion and the patient could do more activities afterward, and that she thought since I was an athlete I would want this. That's how I ended up with the big incision. I could care less.

I have had a lightning recovery. I was out of the hospital in three days, out to dinner after 5 days, driving after ten days. Yes, my muscles were cut and I am walking with a cane, but I have almost all my strength back after less than five weeks and I am doing many asanas already. I plan to go to a gentle class on Christmas Day now that I can get down on the floor. It's because of the Pilates and PT I did before.

I delayed the procedure to get mentally and physically ready. I never expected to become infirm. It scared the shit out of me and I had to come to terms with it. I have consistently denied the amount of pain I was in. I took the pain meds for four or five days after the surgery, but I find I can deal with a fair amount of pain and would rather have my wits about me.

I think I tried not to feel sorry for myself and to be unattached to the outcome. I had been to India twice, I understood a lot about Buddhism, and I summoned my yoga training.

23 December 2006

Well, not quite, but yesterday the physical therapist, after a series of exercises designed to show me just how week my abductors are, also showed me how to get down and up from the floor without breaking the 90 degree rule. This involves going into a standing split, which I easily can do, with the operated leg out behind me, and then sinking on to all fours on the other knee.

90% of the hip replaced population wouldn't care about this, but for me it means I can go back to most of the yoga poses I did before the surgery, with the exception of forward folds and twists. That rocks.

She also had me walk on a treadmill, so this morning I walked on the treadmill for ten minutes in the gym and then rode the bike for twenty minutes. I am back to a half hour of cardio, albeit at a lower intensity, which is where I was before the surgery.

And you are asking why I don't talk about going into the pool? Because the PT told me I weigh the equivalent of ten pounds in the pool, and I determined will never develop walking strength by just walking in the pool.

22 December 2006

Here we are almost at Christmas and I'm still on the cane. But walking better. Nothing hurts. And what I've learned from physical therapy is that I've probably been walking wrong for years. I've always had a very fast, purposeful walk, but it doesn't tuck my tail under me and it doesn't use my hips correctly. I don't wiggle. So I probably haven't had the right walking muscles in many, many years.

Worse, I didn't walk -- I POWER WALKED. Miles and miles. Do I need to know this now--that something I've been doing since I was a year old I've been doing wrong?

I doubt I will ever look like a picture perfect walker. But I can definitely cover some ground.

19 December 2006

OK, I'm four weeks out and I am beginning to draw conclusions about this surgery that I can share. First of all, the American Acadamy of Orthopedic Surgeons has good information about the surgery itself. But it doesn't really have the patient perspective, or the emotional point of view of someone contemplating the hip replacement.

I was terrified. I had never had surgery, indeed never had general anaesthesia before, which baffled my surgeon because I have two children. But I had them during the womens' movement in the '70s and Lamaze (husband-coached childbirth) was getting voguish. I had two natural childbirths. And I left the hospital after a day each time.

But there was no reason to be terrified. It is an easy procedure for the patient, the anaesthesia wears off almost immediately, and if it weren't for the fact that the surgeon carves you up like something out of a bad episode of Nip/Tuck, there wouldn't be pain. There IS, indeed, pain, but it is under the paitent's control because you are given the morphine pump. That's for the first couple of days, and then you get the cocktails of oxycontin and Percoset or Vicodin.

The pain is from muscles, and how much you have is determined by how badly they cut through muscle to do the surgery. Some surgeons don't cut through at all, but I had a procedure where they put a larger femoral head in so I could have greater range of motion and do more things in the future, and so I have a bigger incision. The other pain is from the incision as it heals. Anyone who has had stitches has had this pain.

The pain goes away by the day, and your strength comes back by the day. It's always discernible (or at least every day I could tell I was stronger). Today I went to the gym and got in the pool by myself, and I did my whole workout that I used to do before.

Now, that's because I wasn't afraid of the pain and I left the drugs behind (except for Tylenol) two days after I left the hospital. To me, that made it easier to see where I was at, to resume driving, and to see where I needed therapy (glutes are firing now, and it's time for the abductors).

I attribute my speedy recovery to my preparation. My advice: don't become a couch potato when your hip starts to hurt. Find a stationary bike, or a pool. Make sure you do a half hour of something every day that mobilizes the joint. Go for physical therapy, and learn what muscles help you walk. Develop them: they won't all be cut. Make sure you have upper body strength so you can walk on the walker and the crutches and get yourself out of bed. And take Pilates or some other core strengthener, again so you can get out of bed.

All this makes the recovery shorter. You don't want it to be longer. The physical therapy afterward is tedious and un-fun. And sometimes it hurts. So you want to get through it asap, trust me...

18 December 2006

Yesterday afternoon I got bored so I went to the gym. I got on the exercise bike and rode the full 22 minute cycle and cooldown on level three, with absolutely no pain. Now, was I sore this morning? Absolutely, but who cares? I wasn't any more sore than I was after this morning's physical therapy, because my abductors are really still asleep. Also having an interesting problem levelling my pelvis, because my proprioception is off.

Also saw an article in the paper that Elizabeth Dole is recovering from hip replacement surgery. Like me, she scheduled it for the interstices between appointments :-)

I feel I am almost at full strength. Fewer naps. Less unsteadiness. Easier to climb steps. And I can do a lot of yoga asanas that fall under the hip precautions: half moon, chair pose, camel pose, tadasana, tree, king dancer. Can't turn my left foot in, so I can't do triangle and warriors yet. Also doing wall clock and wall pushups :-) The worst is not being able to get down on the floor.

17 December 2006

Whooo-hooo! Yesterday I met my running buddies (we used to run 60 miles a week together and do marathons, and now we're all around 65 and walk together) by the Biltmore with Chauncey and we walked the canal. Although I had the cane and we didn't go too far, it felt great just to get out there with them again.

For those who wonder how well I walk after less than a month: not the way I want to. I have a limp, which I am trying to correct as I practice walking. It comes from having weak muscles on the left side that don't allow me to change legs the way you need to when you walk. But I have almost no pain -- only a little every once in a while when I move incorrectly--and it is a pleasure to walk.

Today I will take Chauncey out again. Good thing he orbits around me and I don't really have to have him leashed, because I can't really control him on a leash yet. You have to hold the leash in the left hand, the cane in the right, and if he pulled, I be in a face plant immediately.

One sad thought: there's a former Microsoft employee, a friend of a friend, dying of cancer. He was blogging until a few days ago, and now his family is continuing his blog as he is in hospice. His decline is taking place over almost the exact series of days of my recovery.

16 December 2006

Got on the exercise bike today for the first time. It was really painless and I see I can go back to the gym, which is good. I've been procrastinating on the swimming, because it's cold. Also because I don't want to fall getting in or out of the pool.

In physical therapy I am working on the transfer of weight from one leg to another that's involved in walking. Because I had pain before the hip replacement, and because I'm still sore now, I have a terrible hitch in my walk that makes me look like a limper. I don't want to have this, so I am going to have to practice walking big time.

However, if I walk any length of time, I still am in pain, so I will have to wait until all the walking muscles get stronger. This morning I am going out with my old walking buddies to walk on the canal, and I'm going to see how far I can go.

Around the house, I can walk without the cane. On the outside, I still need it because my leg gets tired where the muscles are week. Also because I don't want to reinforce the bad walking

14 December 2006

Spent my first night alone last night, and didn't sleep very well. I'm not sure why, because I didn't have any pain. Just woke up and stayed awake for two hours. So this morning I found myself unwilling to take the chance to go to the gym by myself and get in the pool. I thought perhaps that, being tired, I might have an accident. Instead, I am hanging out on the computer and getting up every hour or so to practice walking.

13 December 2006

I saw Dr. Whirlow yesterday and she decided I could take off my TED sock (yay!) and begin to ride motorcycles again :-)

No, that's a joke. Actually the patient before me in the office was Pat, an acquaintance of min who had her surgery the same day as mine and told Dr. Whirlow "wait until you see Francine and she tells you how she rode the motorcycle." Poor Dr. Whirlow didn't know what to believe, and came in half expecting to be told that I had committed some major violation of the hip precautions.

No such thing: I'm no dope. The most dangerous thing I've ridden in the past two weeks is a barstool. And now that my sentence over, I will admit that I have violated my home imprisonment repeatedly to go to Houston's and to have lunch with clients.

I also walked in the pool and am going to outpatient PT. I have some really bad walking habits, so I will be staying on the cane until I can train my muscles to support my left leg again. This doesn't bother me, as I'm pretty fast on it by now. But I am determined to learn how to walk without a limp.

After three weeks, I am really thrilled by my own progress. Except for the fact that I still don't sleep through the night because I'm uncomfortable after a while in any position, or I accidentally turn on to the incision side, I'm fine and on no pills. I get tired at about 3 PM, but if I take a short nap, I'm good to go again. My next visit to Dr. Whirlow is at six weeks, with another X-ray.

For the first time yesterday I asked what she did, and she assured me that she put in a large head so I could have greater range of motion and more ability to do things like yoga. She told me the implant was made of ceramic, titanium, and one other metal, and that unlike pure ceramic joints, it wouldn't Squeak!

I'm a happy girl. A long three weeks to me, but no one else thinks it was long...I sent the rest of the golden retriever nursing team (Temple, Bodie and Kodie) home to California today. Now I have to nurse my dog out of the depression has has fallen into since they left.

12 December 2006

I went yesterday to the outside physical therapist, who looked at my walk and said she didn't like it. However, when I told her I was only three weeks from surgery, she said I was remarkable. But that doesn't change the fact that my gluteus medius is dead, my quadratus lumborum is tight and not working, and a bunch of other things need work. She gave me a list of exercises and told me I was okay to go in the pool.

So this morning I went to the pool at the gym for the first time in three weeks. I cannot tell you how good it felt! And now a word of thanks to Temple, Chelsea's boyfriend, who got up at dawn to drive me over there and stand by the side of the pool for a half hour reading me the pool exercises, making sure I did them right, and also making sure that I can negotiate the gym and the pool without violating the hip restrictions. We did beautifully! Temple is a born caregiver. And in the pool I do not limp!

11 December 2006

My three week anniversary. As I evaluate the pain, I realize I have no more hip joing pain (of course), but I have lots of other pain: muscle spasms in my glutes are the worst, probably because I exercise and use them all day long. But there is also a burning sensation in my groin that reminds me I've got stitches inside me that are probably still not all healed.

It's hard to sleep, because I have to take precautions not to get into the real fetal position and not to turn over on the unoperated side without a pillow between my legs and not to put my legs in a scissor pattern. Lots of lower back pain as well. When I was on Coumadin, I took two tylenol arthritis for this, but now that I'm on an aspirin that I take every night with dinner, I'm not anxious to take Tylenol as well. I think when I get in the pool this will all get better.

I went to a wind-tasting last night and there was a man there who had had a hip replacement four months ago. He was off the cane and walking well, seemed to be in no pain, but he said the socket was moving around his hip because he didn't grow enough calcium to knot it together. He said he could feel it moving. His surgeon put him on Fosamax to grow calcium. Eeek! That's a complication I had never even read about.

I also spent my first night alone on Saturday night, at Temple spend the night with his family. I was fine, and in the morning I got up and went to Starbucks. Just like old times. I think I am almost ready!

10 December 2006

By the end of June, Bonnie and I were close friends, and I had much more range of motion but no less pain. I began to read about what I'd need in order to recover quickly from the surgery, and there were a lot of references to core strength and upper body strength. So when I left Phoenix for my summer in California, I decided to go for the core strength rather than find another physical therapist.

Somewhere between Bonnie and Pilates I also tried Rolfing. I actually loved it, because it released all the muscular tightness I kept having from trying to walk on my bad hip. Here's what I learned about my particular situation: I don't stop. I will keep going through almost any pain, and probably without meds. That means I will use any muscle or body part necessary to keep me going, whether it's the right one or the wrong one. By the time I got to Bonnie, I had developed a bunch of alternative muscles for walking, while the "real" ones were short and tight. Both Bonnie and Rolfing helped me learn what muscles I needed to develop and what muscles I needed to stretch.

So a big part of keeping comfortable and keeping going was keeping stretched out. I did this both on land through Rolfing and yoga (where I finally quit going to classes and practiced on my own, only poses where I was sitting or lying down), and in the hot tub at the gym, where I could do the standing yoga poses I couldn't do on land.

I also learned to use ice packs on my butt and groin when I had done something really stupid, like walk my dog up a hill near my house.

But the coolest thing I did all summer was Pilates. I found a great studio near my home in California and I spent a fortune on private sessions three times a week on the Reformer. Pilates also taught me new things about my body, especially how to identify all my core muscles and isolate them.

In a way, all this was a gift; I had spent years being an athlete without knowing very much about anatomy and physiology, which was probably how I injured myself in the first place. Because I am very strong for a woman my size, I just powered through things.In all my years of running, even marathons, I never stretched. And even in my yoga teacher training, I did not concentrate on understanding how the muscle groups worked.

Of course I have made up for all this now. I was destined to get these lessons one day, whether I wanted them or not :-) But I think I could actually teach yoga now, because I have come to a greater appreciation of how its early inventors and practitioners came to it.

Oh, I almost forgot: one other little component of my preparation was to stop my other joints from becoming arthritic. To accomplish this, I practiced something my yoga teacher, Jeff Martens, showed me-- the joint-freeing exercises of Mukunda Stiles. These are an excellent series of easy movements that awaken the range of motion in every major joint. I got down on the floor and did these every morning,

Did I have a life apart from exercise and therapy? I guess not, but I got into it and began to enjoy it. I thought it was a wonderful summer. I even managed to keep my business going. Luckily, I work from home and control my own time!

09 December 2006

Bonnie Kurth is a physical therapist who specializes in hips. I went to her for three months, and I learned several things from her: less is more, walk with a cane to minimize pain, and the key muscle for gaiting is the gluteus medius.

Because my hip joint had been collapsed for a long time already,my gluteus medius had gone to sleep, along with a bunch of other muscles that work with it. Before I could strengthen them, I had to stretch them, and Bonnie and I spent a month stretching, which did a lot to relieve my pain. I refused to take drugs, so I was always in pain.

But the anti-inflammatories didn't really do much (and Celebrex carried an increased risk of heart attack) and the idea of taking pain killers and messing with my mind didn't appeal to me. So no drugs.

Bonnie convinced me, while I was laying on her table and she was trying to do trigger point release on me, that I should walk with a cane because she was going to hurt me in order to help me. While I didn't like it, I found a web site called Fashionablecanes.com and ordered a couple of great canes -- one was a replica of an 18th century Royal French walking stick, and the other a spring floral pattern. They made a fashion statement that I wanted to make.

Like me, Bonnie had two dogs, and we were drawn to each other by our understanding of how dogs think (or how we think they think). Because of this, I let Bonnie do some really strange things: for example, she would put a belt around her own waist, and around my leg, and try to dislodge the femur from the acetabulum to give me more range of motion. She was pretty successful in doing that, and I regained much of the range of motion I had lost.

I also switched from painfully walking the canal with my girlfriends in the morning for exercise to water aerobics and walking with the Aquajogger belt. And Bonnie made me aware that I was causing myself more problems by exercising through my pain, because I was compensating too much, This meant I was using all the wrong muscles to do things, and letting the "right" muscles, the ones I'd need after surgery if I had it, atrophy.

Not a big surprise; I've always been partial to outcomes rather than process. I had never studied the process of walking and running, just gone for the outcome. Now, I got to learn what goes into walking--all the little muscles that influence gaiting, like the ilio-psoas, the gluteus medius and miminus, the adductors and abductors. Throw into all of that the functions of the spinal erectors and the core, and you get to realize how complicated this process of walking on our hind legs truly is.

08 December 2006

The nurse and the physical therapist came yesterday and discharged me. All my vitals are stable, I'm off the drugs, and I can do all the exercises without help. Except that now she has given me balancing poses: walking forward on my toes and heels, semi-lunges, and balancing on one leg (tree pose). Can't do tree pose yet, but that's a good multi-task for while I brush my teeth.

Ed and I celebrated by going to dinner in the bar at Capital Grille. Tip: barstools are easier to get in and out of than chairs. I've always loved to eat in the bar anyway.

More about how I prepared.

I am on the board of a private school in Paradise Valley. We had a nominating committee meeting one day after my Tucson visit, and one of the women on the nominating committee was a retired orthopedic surgeon. She told me she had practiced many years ago with a woman named Janet Whirlow, and that Janet was the kind of doctor who would look at the interconnectedness of body, mind and spirit, not to mention the interconnectedness of hip and back.

So I made an appointment, and when I got into Janet's office I felt like I was home. Disclaimer: remember I am 65 and grew up in an era when men dominated medicine. Although I actually have had two wonderful female internists, I've NEVER seen a woman surgeon before,and I thought I was going to have to make a mental leap to trust Janet. She's about 5'3", weighs about 100 pounds, and looks -- well --pretty. I have a hilarious mental image of her in the operating room standing on a box to get above some 300-pound guy strapped to the table as she takes the saw, hammer, and drill to his hip. Hip surgery, after all, is carpentry. Period.

Janet took my X-rays and put them up on her light board. She didn't dismiss the idea that a hip surgery could screw up my back. She didn't tell me I should forget about yoga. And because she took the time to talk to me, I began to cry in her office. I told her the other surgeons really treated me like a disembodied hip, that I had never had surgery with general anaesthesia before, and about my fears. She told me she had left a large practice because she wanted the time to talk to people like me.

She also told me that I should train for the surgery, and that I'd have a better result if I didn't rush into it, but took the time to get ready properly. She told me that I would have to donate my own blood, that I would need about six weeks to recover because my surgery would not be minimally invasive, and that minimally invasive surgery wasn't really appropriate for me, because in order to equalize my leg lengths, straighten out my pelvis to protect my back, and position the hip properly so it wouldn't dislocate if I went back to yoga, she would have to open me up enough to actually see the joint. It made sense.

Then she told me I wasn't mentally ready for surgery and probably would be better off waiting until I was, and she recommended me to a physical therapist. And not just any therapist, but a hip expert.

This was May. My birthday was the 14th, and I had scheduled the Tucson surgery right after, so it would be covered by Medicare. By this time, although I was limping pretty badly, I was still terrified about going to the Tucson surgeon, even though he was minimally invasive, so I bailed. I called and cancelled. This meant I could not have surgery again until Thanksgiving, because I was planning to leave Arizona for the summer, and then I was going on a cruise to the Italian Mediterranean in September, and then I was producing the First Annual Arizona Entrepreneurship Conference in early November. So I put off the decision, and instead decided to try everything else in a wild effort to avoid surgery.

07 December 2006

Last night I realized that I started this blog in a moment of pique about the admissions process at Scottsdale Healthcare North and its pre-admission process. That, however, does not help the person planning a hip replacement. So I'm going to back track a year, to when I got back from China and realized I was limping. Or rather, people told me I was limping.

I ignored it, powered through the pain, and was determined, at least, to wait until I was on Medicare to do something about my hip, because I had the kind of health insurance that entrepreneurs have -- very little. So the first part of my plan was to wait until May, when I turned 65.

To do that comfortably, I switched my yoga practice to a less strenuous one from Power, after which I used to emerge really trashed. I also began to exercise in the pool at my gym. I didn't want to wet my hair every day swimming, so I walked in the water. And I did pull-ups on the ladder. At first I hated it. But then as always, some really nice people manifested and I formed a new community of pool exercisers -- a man with MS and his caregiver, an older woman who hiked first and then walked, and some Europeans who just believed water exercise was good for you.

By May, however, I was in considerable pain. So I started asking around for people with experience. One of my yoga teachers had a friend in Tucson who had had a new, minimally invasive procedure and was up in seemingly no time with a tiny scar. Ed and I went down to see him. He had learned the procedure in Europe. He had done a lot of them. He acted like it was NOTHING. I asked him a lot of questions about my back and its relationship to my hip, all of which he dismissed with the "don't you worry little lady" attitude of the guy who does 50 surgeries a week, and then he fobbed us off on his office staff.

We did schedule the surgery (same way I put deposits down on new real estate projects as long as they are refundable), and then I went home and started to talk to friends and family.

The logistics of having surgery in Tucson weren't optimal, but they were doable. One of my deal breakers was not to have to go to a rehab facility, however, and we quickly learned I couldn't drive or ride home to Phoenix until I had the staples out. Hmmm. Ten days in a hotel. Or go to the rehab and have Chelsea stay in the hotel.

So I began looking for surgeons in Phoenix who might do that same procedure. At the same time, I had two nagging fearsL

1)the hip surgery would aggravate my back issues, which are not trivial, but which I have always controlled with yoga. After all, when you are a yoga teacher you learn that the "hip bone's connected to the thigh bone, the thigh bone's connected to the knee bone, now hear the word of the Lord." (Old folk song) Often, if you change one thing that relates to the spine, everything else also changes (often for the worse).

2)I would never emerge from the anaesthesia with all my marbles. My mother didn't, so this wasn't just idle anxiety.

06 December 2006

I have been trying to write every day about the hip replacement, for others who might have to have one. I do it when I get up in the morning, before everything else intervenes.

I'm now more than two weeks out, and I feel as if I am in the same amount of pain I had before the surgery, but for different reasons. Now the pain is not in my hip, but in my back from general lack of exercise, I feel like I can take care of that problem in a couple of weeks when I am allowed to do things again.

In the mean time, I am now at the point where I am walking with just the cane, and even bouncing off the walls of my house without anything, I feel very steady, and I am going to start driving, since this is my left hip. In week three I can legally go out without losing my Medicare benefits (the home nurse and the therapist) and I will be thrilled to resume my life just in time for all the Christmas parties, Not that I haven't been walking around on my block and in my yard :-)

The scar is healing beautifully, It's big: probably over a foot long. I had a lot of staples. I think that's because Dr. Whirlow had to really look at my pelvic area and back to see how to place the new joint so I could go back to all my previous activities. When I see her on Tuesday I am going to ask her how she did it, and what muscles she cut. I'm getting them back slowly, but I can see now that I will be going to therapy for a long time. I guess that's why people say the rehab is difficult. It is.

Before I had this surgery, I never realized how many things fall to the floor as a matter of daily life. Now, since I have to go find the grabber to go pick anything up, I am acutely aware. Sometimes the cane falls over. Last night I dropped a package of applesauce out of the refrigerator, And feeding the dogs is a logistical challenge; if I leave their bowls on the counter I can load them with food and feed the boys on the banquette in the kitchen. Then no one, even them, has to bend over. But last night Temple fed them on the floor, and didn't pick up the bowls. This morning, when I went in to feed them: GET THE GRABBER, BOYS!!! They don't understand all this complexity, which is why I love them.

05 December 2006

No one talks about the emotional side of the hip replacement. But believe me, there are issues.

No one likes to be helpless, least of all me. But I realized I couldn't do this alone, so I asked one of my children to help. We did our best to pre-plan, especially for the fledgling businesses she and her SO own. All of us are self-employed and decided that a good time for us would be between Thanksgiving and Christmas when our workloads typically slow down. She brought her family so she could stay for a long time without missing them.

We all had the best intentions. And we thought we had planned.But from the very beginning, there were problems.

Minor: My house wasn't set up for visitors: no TV in the guest room, small bathrooms, and problems with thick plaster walls and wireless Internet. Rental car too small for dogs.Somewhat major: She got a request from a client for a project just before the surgery. Another client also wanted her to work with him before Christmas.Very super ultra major: Neither of us was used to the role reversal of mother being waited on by daughter.

After two weeks of me desperately trying to be a manager and make the house more hospitable for her business from my hospital bed (endless calls to Cox, purchase of a TV,etc) and two weeks of her trying to work in between fetching bottles of water for me, emptying the garbage, bringing me food, and helping me dress, our relationship was completely frayed.

She was desperate to get home to an efficient work environment and some quiet time to work on the projects. I was tired of hearing her complain and watching her (after all, she's my baby) be miserable. Her SO wanted to stay in Arizona and be with his family for Christmas. The dogd were still busy nursing me. We had serious agenda conflict.

After more yelling and screaming than has ever gone on in our family before (we are usually not disfunctional) the obvious solution emerged:last night, she flew home. The SO and the wonderful boys are here making my life easier.

This was all devastating to me until it resolved, and it gave me a glimpse of what old age, with its increasing dependence on others, will bring. The good news is that this is not a serious illness, and by next week I can go out. The other good news is that I have had a few epiphanies about how I ought to plan for my future ( or rather, THAT I have to plan for my future :-) Just in time.

04 December 2006

I've reached the point in my recovery where I am still grounded but too energetic to be happy at home. It's after 1 AM and i have been up for a hour. I'm just simply not tired because I was in bed most of the day. I've graduated pretty much in the house to the cane from the walker, and I've done all my exercises.

I'm sure once I am allowed to go out and do daily activities I will be exhausted, because I feel my energy levels varying during the day. But right now, I am sitting bolt upright in bed, typing away. It's not even that there's something on my mind that's keeping me awake, or any pain to speak of. Today I did so little that I didn't even have to take a Tylenol. After a day or two of doing a new series of exercises, I can do them without pain. Although I notice that I still have weak glutes, quads and abductors in the operated leg.

There is also no Internet in the house. We bought a new TV, plugged it in, and destroyed the broadband signal. Cox sent someone over who got it going temporarily, but as soon as he left the house it quit again. I called again, but they couldn't get a technician over until Wednesday. This is Sunday. So I have been calling repeatedly, telling them I am bedridden, telling them I have no home phone without broadband (I have VOIP) and hoping someone cancels an appointment.

Cox has tried to improve its customer service, but it still sucks. One tech on the phone was nice enough, but when I told him I really needed the Internet, he told me to read a book or watch TV. Another tech who I told I didn't want to be housebound without a home phone asked me if I could have someone come over and stay with me. He said, can't you call a family member to come over? What a jerk! Could never have thought of that myself. And of course a family member is here. But what if she weren't????? The phone company used to be mandated to supply service to elderly and handicapped people living alone, but I don't think the Internet has that kind of mandate. I guess it shouldn't, as a regulation, but perhaps the customer service reps should be trained to make different answers when someone tells them they are homebound, just had surgery, live alone, and are also trying to support themselves on the Internet.

03 December 2006

Today I walked around the house a little on the cane. When I do it, I can see how weak my left leg is. Some of my muscles have just atrophied, while others were cut or moved in the surgery. It won't be long before I am up and about on the cane and back out in the world, but it might be while until I can hold tree pose for 60 seconds on the left leg. But I couldn't before, either.

02 December 2006

Yesterday was a busy day, and I had to take Tylenol to get the three series of 18 exercises in comfortably. But I am feeling like I could get off the walker -- in fact, I walked from the bedroom to the bathroom on my cane in the middle of the night twice. The only reason I wouldn't try it all day long is that I can feel that the left leg is still weak, and there are four large doggies running around my house. I don't want to fall.

I'm less than two weeks out from the surgery, for those who are contemplating having it, and I have very minimal pain today -- almost none. Without even Tylenol.And I didn't have a minimally invasive procedure. My large scar is pink.

Every time your do those exercises, they get easier, and the advance from day to day is phenomenal.

I am also self-sufficient for dressing, showering, and calling out for food :-) My family and I are beginning to have our customary fun together!

01 December 2006

Much better day. The physical terrorist gave me 18 exercises, each to do 3x a day, so that takes up the day right there. Then Olivia, a housekeeper I have had for over ten years who has also taught me Spanish, came in and cleaned the house from top to bottom. What a great feeling! What a dear friend she is, like my landscaper Rafael, who brought me the sweet bread and pear nectar from the Guatemalan grocery. And then my friend Steve came by with pizza from La Grande Orange!

Better yet, here's a link to someone who has written in his own blog about my hip replacement blog: